MCW Rheumatologist | Rheumatology Program Dir | Med Dir Vasculitis Program | Internal Medicine APD | Host, EBRheum Podcast | ebrheum.com | Newsletter:
Joined January 2018
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6 May 2021
May as well join the fun: TYPES OF [X] PAPERS - RHEUM-EDITION!
Special thanks to @BenMazer for this article theatlantic.com/science/arch…
And to this website: observablehq.com/@guillaume-…
And sorry if someone already did this! Had not seen yet for rheum but wouldn't be surprised ;)
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Excited to share my newest (biggest?) project ever: boardsbank.com!
- Rheumatology boards-prep question bank
- 1,000 board-style questions w/full vignettes & explanations
- All mapped to ABIM blueprint categories, updated constantly
- Hundreds linked to guidelines
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Jun 4
Spicy newsletter this week on #peptides, BPC-157, and the upcoming #FDA meeting to discuss their status
I can cut to the chase on this one: BPC-157 is pseudoscientific nonsense. Have a read!
autoimmunedevreport.substack…
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May 6
Substack out today, discussing the FDA's recent notice regarding avacopan
autoimmunedevreport.substack…
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Mar 15
New article out this morning! Deucravacitinib now approved for PsA. Thoughts on what it means / how big this will be as well as a nifty infographic I've been working on
Check out out and subscribe below!
open.substack.com/pub/autoim…
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Mar 12
What's happening w/the FDA & avacopan?
Have you heard of brepocitinib yet?
And how is ALLEGORY going to fit into the current landscape of SLE therapies?
New newsletter! Have a read & follow along: Avacopan Under Fire & B Cells are Having a Moment
open.substack.com/pub/autoim…
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Is it time for rheumatologists to prescribe GLP1’s?
New data hints at better disease control in rheumatic conditions, and @ebrheum discusses whether it's time for rheumatologists to start prescribing them.
Read here: buff.ly/FblQUJ4
#Rheumatology #GLP1 #MedTwitter
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Feb 8
Same story with nipocalumab. Worked for ESSDAI, not ESSPRI
Story for telitaciecept complicated...
Matt Baker "We don't usually see this kind of non response for patients in placebo groups"
I'll say it a little more bluntly: I don't believe this data. #RNL26
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Feb 8
Assuming ianalumab will be coming soon to a NEJM / FDA near you
Successful in ESSDAI but not really in ESSPRI... 😤
No benefit at all in pts w/low salivary flow at baseline
What do we do with a marginal drug that costs >$100k/yr (assuming) & no benefit in ESSPRI? #RNL26
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Feb 8
I really dislike ESSDAI as an outcome measure, ESSPRI makes way more sense
Covers dryness, fatigue, and pain - aka "what matters most to most patients with Sjogrens"
Neither baseline nor change in ESSDAI & ESSPRI correlate with each other (r=0.20 & r = 0.14!)
#RNL26
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Feb 8
My new favorite myositis specific antibodies slide, c/o Dr. Rohit Aggarwal
Highlights the re-classification of prior cases of "polymyositis"
Covers nuance with CCAR1 & TIF1y pts (ie low risk of CCAR1)
HJighlights lung cases (ie MDA5, overlaps, antisynthetase) #RNL26
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Feb 8
Classic slide from Dr. Aggarwal, CK values skew rightwards, causing completely-normal values to be flagged as abnormal #RNL26
I use ~300 for women & ~500 for men w/wiggle room for BMI, muscle mass, and recent activities
Great slide here non-rheum causes of CK elevations
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Feb 8
If you're looking for information about the FDA/EMA-avacopan drama, some surprising nuggets in the publicly available legal documents
None of this is new-to-the-FDA/EMA, but I bet some of it will be new-to-you. See 133, 136, 141, & 142, 175
chemocentryxsecuritieslitiga…
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Feb 8
Epic summary slide of current approvals and trials for SpA, I wish someone just maintained a website that updated things like this constantly. So useful for practice. #RNL26
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Feb 8
Interesting pearl #RNL26 - re:imaging for AxSpA, MRI is better at the SI joints, CT better at the spine
Nice slides highlighting extra-axial manifestations in this disease
Uveitis is particularly tough: "For refractory uveitis, high dose JAK may be an option" -Dr. Bakewell
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Feb 8
Revised calssification criteria for axSpA #RNL26
Pretty reasonable list, I like that we're giving more credence to various common manifestations (IBD, uveitis, enthesitis, etc)
Lots o'points for MRI findings... still easy to overdiagnose
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Feb 8
Great talk at #RNL by Dr. Poddubnyy - strongly recommend this paper from Lancet Rheum discussing the "imaging crisis" in axspa
More sensitive evaluations find more axspa BUT also more false positives, resulting in overdiagnosis & overtreatment
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Feb 7
JAKi's for allopurinol hypersensitivity? Have never seen it, but nice to have this in the back of your mind if you do #RNL26
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Feb 7
Gout talk by Dr. Terkeltaub - really convicing me to try febuxostat first, no risk for allopurinol hypersensitivity & easier to uptitrate #RNL26
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Feb 7
Gap between where we should be (controlling gout for everyone for under $100 per year) & where we are is vast. Great slide & stark rundown from Dr. Terkeltaub
Also, description of the CARES trial: "Got a black box from a crappy trial that was a piece of crap" 😆#RNL26
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Feb 7
Lots of great pearls for IL23 vs IL17 at #RNL26 from Dr. Ribeiro
IL17A < IL23 for PSO... but what about IL17A/F? RCT pending
For joints, TNF ~ IL17 ~ IL23, but some skepticism about IL23 in axial disease
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